Preparation of specific antibodies against murine IL-1ra and the establishment of IL-1ra as an endogenous regulator of bacteria-induced fulminant hepatitis in mice

Blocking monoclonal antibodies (mAbs) specific to mouse interleukin-1 receptor antagonist (IL-1ra) were prepared by immunizing Armenian hamsters with recombinant mouse IL-1ra. A sensitive and specific ELISA against mouse IL-1ra was also established. In Propionibacterium acnes-induced liver injury, P. acnes induced transient increase of serum tumor necrosis factor-alpha levels but not those of IL-1ra, IL-1, and IL-6. However, subsequent lipopolysaccharide (LPS) challenge induced the increase of serum levels of all these cytokines and the peak serum IL-1ra level was more than 20 times as high as serum IL-1 levels. Immunohistochemical analysis demonstrated that IL-1ra was predominantly produced by hepatocytes during the course of the priming phase by P. acnes and eliciting phase by LPS challenge. Furthermore, the administration of a mAb to mouse IL-1ra exacerbates the liver injury induced by P. acnes and sublethal dose of LPS, suggesting a protective role of endogenous IL-1ra in this liver injury model.

Expression of angiotensin-converting enzyme in renovascular hypertensive rat kidney

We hypothesized that the gene expression of angiotensinogen, angiotensin-converting enzyme, and angiotensin II type 1 receptor, in addition to renin, is increased in kidneys after renal artery stenosis. Two-kidney, one clip renovascular hypertension was initiated in Sprague-Dawley rats by clipping of the left renal artery; control rats were sham operated. Blood pressure was not changed for the first 2 days after clipping but was elevated on day 4 (mean arterial pressure, 104 +/- 4 versus 87 +/- 2 mm Hg in sham-operated control rats, P < .002) and increased further during the next 24 days. Rats were killed 2, 4, 7, 14, and 28 days after clipping or sham operation, and poly(A)(+)-purified renal cortical RNA was analyzed by Northern blotting. Autoradiographs were quantitated by densitometry and normalized for the expression of a housekeeping gene. Renin expression was increased in the clipped kidney (by 149% on day 2) and decreased in the nonclipped kidney (by 82% on day 2), compared with kidneys of control rats. Expression of the angiotensin-converting enzyme was increased in clipped kidneys from the first day after clipping (158%) and throughout the experiment (66% on day 28), but was unchanged or slightly decreased in nonclipped kidneys. Angiotensinogen mRNA showed little change. Angiotensin II type 1 receptor expression was decreased in nonclipped kidneys but unchanged during the first 7 days in clipped kidneys. Our results show that components of the renin-angiotensin system other than renin are also differentially expressed in clipped kidneys.(ABSTRACT TRUNCATED AT 250 WORDS)

Factors influencing growth rate of recurrent stomach cancers as determined by analysis of serum carcinoembryonic antigen

BACKGROUND

Although there are many reports regarding the growth rate of human tumors, those discussing stomach cancer are rare due to the difficulty in evaluating the growth rate of stomach cancer. Stomach cancers grow with either a large central depression or through severe invasion. Metastatic sites of stomach cancer, however, grow expandingly, as with pulmonary tumors.

METHODS

The reported doubling time estimate, based on the serum level of carcinoembryonic antigen (CEA), agreed with the actual tumor doubling time investigated in 112 previously untreated patients with recurrent gastric cancers. The influencing factors of the CEA doubling time were studied clinicopathologically, and a possible correlation between postoperative survival and the CEA doubling time was noted.

RESULTS

The CEA doubling time ranged from 12 to 105 days, with a mean of 37.5 +/- 20.5 days (mean +/- standard deviation) and a median of 32 days. The CEA doubling time did not differ significantly between sexes or between patients of varying ages. However, the CEA doubling time was significantly shorter in patients with papillary adenocarcinoma than in those with well or moderately differentiated tubular adenocarcinoma. The CEA doubling time of patients with poorly differentiated adenocarcinoma was divided into two groups--a shorter one and a longer one. The doubling time was also significantly shorter in patients with liver metastasis than in those with lymph node metastasis or peritoneal dissemination. Furthermore, among patients who did not receive any chemotherapy, a significant correlation was observed between the CEA doubling time and postoperative survival time. Most treated patients survived longer than untreated patients.

CONCLUSION

The influencing factors on growth rates in recurrent stomach cancers were histologic type and metastatic sites. This growth rate plays an important role in determining the degree of biologic malignancy and may be influenced by some chemotherapeutic regimens.

Mutant K-ras in apparently normal mucosa of colorectal cancer patients. Its potential as a biomarker of colorectal tumorigenesis

BACKGROUND

The best way to reduce the incidence of colorectal cancer mortality would be to prevent this cancer. However, none of the biomarkers proposed can accurately identify persons at increased risk of colorectal cancer or those at low risk. As a possible genetic biomarker, K-ras mutations, which are frequently found in colorectal cancers, were analyzed in apparently normal colorectal mucosa.

METHODS

Nonneoplastic mucosa and tumor tissues were collected at surgery from 70 patients with colorectal cancer: one sample each from 50 patients (group A) and multiple samples from the other 20 patients (group B). Mutant K-ras codon 12 was analyzed by the enriched polymerase chain reaction (EPCR), by which one mutant can be detected among 10(3) to 10(4) normal alleles.

RESULTS

Only with the aid of EPCR was mutant K-ras detected in nonneoplastic mucosa of nine patients (18%) in Group A and five patients (25%) in Group B. This increased incidence could be attributed to the multiple tissue sampling. The presence of mutant K-ras in nonneoplastic mucosae was not consistently correlated with that in the tumors. These findings suggest that the mutant K-ras identified in nonneoplastic mucosa actually represents de novo mutations, which may be initiated by different etiologic factors and at different times.

CONCLUSION

Mutant K-ras detected in apparently normal mucosa should be a useful biomarker for identifying persons at higher risk of colorectal cancer. Our study also emphasizes the need for improving the method for sample collection to achieve true representation of the colorectal mucosa.

Molecular analysis of the cytokine network involved in cachexia in colon 26 adenocarcinoma-bearing mice

Two clones, one cachexigenic (clone 20) and the other noncachexigenic (clone 5), from a murine colon adenocarcinoma, colon 26 cells, were used to analyze the involvement of immune reactions as well as the cytokine network in cachexia. Clone 20 induced cachexia in nude and SCID mice as well as in normal BALB/c mice, suggesting that lymphocytes played little, if any, role in the process. Both clones failed to express mRNA of interleukin (IL) 1 alpha, IL-1 beta, IL-6, and tumor necrosis factor alpha in vitro with or without the coculture of NIH3T3 cells or spleen cells. However, IL-6 mRNA was selectively detected at the tumor site of clone 20 but not at that of clone 5-bearing mice. In contrast, tumor necrosis factor alpha mRNA was detected at tumor sites and in spleens of only clone 5-bearing mice, suggesting a potential role of IL-6, but not tumor necrosis factor alpha, in inducing cachexia. Anti-IL-6 antibody partially reversed the weight loss induced by clone 20, whereas the continuous infusion of IL-6 failed to cause weight loss, despite being associated with an elevation of a serum acute phase protein. These results suggest that IL-6 is necessary but not sufficient for the induction of cachexia. Both clones expressed IL-6 mRNA in the presence of IL-1 in vitro, and mice bearing either clone expressed IL-1 beta mRNA at the tumor site. Moreover, IL-1 receptor antagonist (IL-1Ra) mRNA was detected at the tumor site of clone 5-bearing mice but not at that of clone 20-bearing mice, suggesting that IL-1Ra might block IL-1 activity to reduce IL-6 production in clone 5-bearing mice. However, the transfection of clone 20 with IL-1Ra cDNA failed to abolish its capacity to produce IL-6 and to cause cachexia. Collectively, additional factor(s) besides IL-1Ra and IL-1 beta may control IL-6 and some other cachexigenic factor production, thereby causing cachexia in this model.

Superficial-type adenomas and adenocarcinomas of the colon and rectum: a comparative morphological study

BACKGROUND/AIMS

It has been uncertain whether colorectal carcinomas preferentially arise on preexisting adenomas or de novo. However, from a morphological viewpoint, it seems unlikely that pedunculated or exophytic malignant polyps progress to the deeply ulcerated advanced carcinomas usually found clinically.

METHODS

The morphological features of 26 nonpolypoid, superficial-type colorectal tumors (17 adenomas and 9 adenocarcinomas) were compared to clarify the developmental route of colorectal carcinomas.

RESULTS

The adenomas and adenocarcinomas were very similar in size and gross appearance; however, examination of the surface appearances of unsectioned tumors by dissecting microscopy was helpful for distinguishing the two. Histologically, no adenomatous tissue was found in any case of superficial-type adenocarcinoma. Five of the nine adenocarcinomas, even including those of small size, invaded the submucosal layer, and two showed lymph node metastasis.

CONCLUSIONS

These findings suggest that superficial-type adenocarcinomas show rapid growth and aggressive behavior. We suggest that this type of carcinoma may not progress by the adenoma-to-carcinoma pathway but that it may arise from a very small superficial-type adenoma.

Infrequent K-ras activation in superficial-type (flat) colorectal adenomas and adenocarcinomas

Clinicopathological evidence is accumulating that a superficial-type (flat) colorectal tumor is a distinct neoplastic entity. To clarify the genetic characteristics of this tumor, we investigated the K-ras gene mutations and morphological features of 43 tumors of this type. A mutation of the K-ras codon 12 was detected in only 5 (16%) of 31 adenomas and 2 (17%) of 12 adenocarcinomas. The presence or absence of this mutation was not correlated with the tumor size or stage or with histopathological findings. None of these tumors had a mutation in codon 13 or exon 2, including codon 61. This low incidence of K-ras mutations (16%) suggests that superficial-type colorectal tumors are etiologically distinct from ordinary colorectal polypoid tumors and that there may be an alternative pathway of colorectal tumorigenesis.

Renal cell carcinoma producing alpha-fetoprotein (AFP) with a unique lectins-affinity profile

Renal cell carcinoma (RCC) producing alpha-fetoprotein (AFP) is a rare entity and merely 7 cases have been reported so far. The present case, a 71-year-old woman, showed a high serum AFP level of 204 ng/ml. The RCC of the autopsied right kidney consisted mainly of spindle-shaped or bizarre sarcomatous tumor cells. AFP was immunolocalized only in the concomitant clear cell component. Concanavalin A (Con A)-nonadsorption rate of serum AFP was 42%, which was an intermediate value between those of yolk sac tumors and metastatic liver carcinomas. Lens culinalis agglutinin (LCA)-affinity study of the patient's AFP showed an unknown peak X, which was eluted between the known peaks 2 and 3. These results suggest a certain structural alteration in carbohydrate moieties of the AFP derived from this RCC. A review of the clinicopathologic features of 8 patients with AFP-producing RCC was made to understand the pathophysiology of AFP-producing neoplasms.

[Neoadjuvant chemotherapy for far-advanced gastric carcinoma]

Far-advanced gastric carcinoma of the stomach remains a lethal disease, showing a particularly poor prognosis in the patients with linitis plastica type. Considering the high potential for biological malignancies, we attempted preoperative induction (neoadjuvant) chemotherapy against far-advanced cancer associated with distant metastases. Anticancer drugs used in this study were FAM or sequential MTX/5-FU. Neoadjuvant chemotherapy was carried out on 24 patients prior to surgery. The response to chemotherapy showed shrinking of massive nodal involvement in 50% (5/10) and complete disappearance of malignant ascites in 87.5% (7/8). The morphological improvement of primary gastric lesions was obtained in 9 out of 24 cases (37.5%). In 15 cases (68.2%) total gastrectomy was done with extended lymph node dissection. In one of 9 cases showing marked improvement, no viable cancer cells were seen in whole stomach associated with multiple foci of granulomatous lesions of regional nodes after 3 cycles of MTX/5-FU. Disease-free survival of neoadjuvant group showed a significant prolongation of its median survival of 14 months, compared to that of 4-6 months in the surgery alone group. Our result leads to the conclusion that the patients whose tumor was effectively destroyed by neoadjuvant chemotherapy had a good prognosis.

Expression of type-IV collagenases in human tumor cell lines that can form liver colonies in chick embryos

Chick embryo has been used as a model system for evaluating the metastatic potential of tumor cells. We have previously demonstrated that expression of the tissue inhibitor of matrix metalloproteinase-I (TIMP-I) gene can suppress liver colonization of tumor cels in chick embryo, probably by inhibiting the activity of matrix metalloproteinases (MMP) produced by tumor cells. In an attempt to identify MMP associated with liver colonization, we examined 24 human tumor cell lines for their potential to form metastatic colonies in chick-embryo liver after the cells had been inoculated into the chorioallantoic membrane (CAM) vein. We compared the results with the mRNA expression of MMP (MMP-I, MMP-2, MMP-3, MMP-9) studied previously. Three of 8 cell lines from mesenchymal tumors (fibrosarcoma HT1080, osteosarcomas SK-ES and MNNG/HOS) and 2 of 16 cell lines from epithelial tumors (gastric carcinoma KKLS and bladder carcinoma T24) proliferated in the livers. MMP-2 and MMP-9 were the enzymes whose transcripts were more frequently expressed in these 5 metastatic cell lines (MMP-1; 2/5, MMP-2; 4/5, MMP-3; 0/5, MMP-9; 3/5), but other cell lines that did not form liver colonies expressed the transcripts at lower frequency (MMP-2; 7/19, MMP-9; 3/19). Although either or both MMP-2 and MMP-9 transcripts were expressed in 4 of the 5 metastatic cell lines, they were undetectable in T24 cells. However, induced expression of both enzymes was detected by immunostaining in the T24 cells colonized in the liver. Thus, type-IV collagenases expressed by tumor cells may play a role in facilitating colonization in chick embryos.

Early interstitial changes in hypertension-induced renal injury

To elucidate the mechanisms of hypertensive renal injury, we investigated the time course and extent of changes in matrix composition, as well as cell proliferation and infiltration in two-kidney, one clip rats. The nonclipped kidneys from hypertensive and sham-operated control rats (n = 5 to 10 in each group) were studied at 7, 14, 21, and 28 days after clipping. Systolic blood pressure was elevated by day 7 (154 +/- 3 versus 111 +/- 4 mm Hg in sham group, P < .001, n = 10 each). Hypertension resulted in an early expansion of the interstitial volume by 37%, whereas hypertensive vascular changes and glomerular injury did not become evident until day 21. Immunofluorescence studies revealed an early interstitial accumulation of collagens I, III, IV, V, VI, and fibronectin by day 7. In contrast, the glomeruli showed a mild to moderate increase in collagens I, III, IV, V, laminin, and fibronectin but not collagen VI later in the established phase of hypertension. Staining for proliferating cell nuclear antigen as a marker of cell replication was increased in tubular epithelial but not interstitial or glomerular cells. A progressive infiltration of macrophages (16 +/- 2 versus 9 +/- 1 ED1+ cells/mm2, P < .05, n = 6) and T lymphocytes (93 +/- 15 versus 74 +/- 7 CD4+ cells/mm2, n = 8) in the cortical interstitium had already occurred by day 7. On the other hand, only macrophages increased in number within the glomeruli. Thus, renovascular hypertension leads to an early tubular cell proliferation, mononuclear cell recruitment, and deposition of matrix proteins primarily within the interstitium. We conclude that the injury producing nephrosclerosis in this model extends far beyond the glomeruli. Both the tubules and the interstitium are actively involved and may be the more important initial sites of injury.

Vascular conversion of angiotensin I in stroke-prone spontaneously hypertensive and Wistar-Kyoto rats

OBJECTIVE

Linkage studies have shown that the gene locus for angiotensin converting enzyme (ACE) is associated with the expression of hypertension in stroke-prone spontaneously hypertensive rats (SHRSP). We tested the hypothesis that the conversion of angiotensin I (Ang I) to angiotensin II (Ang II) in blood vessels is elevated in SHRSP.

DESIGN

We measured the conversion rate of Ang I to Ang II during one pass through an isolated resistance vessel bed. We used the same substrains of SHRSP and Wistar-Kyoto control rats (WKY) that had been employed in the earlier linkage studies.

METHODS

Isolated hindquarters from young and adult (10- to 12- and 36- to 38-week-old) rats were perfused with an artificial medium and then infused with Ang I at 0.5 and 2 pmol/ml. Ang I and II were measured with high-performance liquid chromatography and radioimmunoassay in hindquarter effluent and in blank control channels. Conversion and extraction rates were calculated from angiotensin levels in hindquarter and blank perfusion channels, respectively.

RESULTS

The conversion rates of Ang I to Ang II did not differ between SHRSP and WKY in young or in adult rats. Captopril completely abolished the formation of Ang II in all groups of rats. During infusion at the higher dose of Ang I, the extraction of Ang I was significantly decreased in SHRSP compared with WKY.

CONCLUSIONS

Our results are consistent with the notion that the metabolism of angiotensin is decreased in spontaneously hypertensive rats. However, we found no support for the hypothesis that vascular ACE is responsible for high blood pressure in SHRSP. These findings suggest that other genes close to the ACE locus or the hyperexpression of the enzyme in other areas may contribute to hypertension in these rats.

A study into the phenomenon of head-shaking nystagmus: its presence in a dizzy population

In this paper we have prospectively analyzed results from approximately 1,500 patients who underwent a head-shaking test during routine electronystagmography (ENG). The incidence of head-shaking nystagmus (HSN) in a dizzy population was relatively high (31.7%) when compared to other so-called abnormalities in the routine ENG test battery. Its presence was also similar in both active vs. passive head-shake tests. When present, different types of HSN were identified (monophasic (76.8%), biphasic (22.7%) and triphasic (0.5%)). In some cases, reversals of the expected "normal" pattern occurred. A high correlation was found to exist between a positive head-shake test and the presence of spontaneous nystagmus, positional nystagmus and caloric test abnormalities.

Early invasive colorectal carcinomas metastatic to the lymph node with attention to their nonpolypoid development

Clinicopathologic study of six cases of early invasive colorectal carcinoma metastatic to lymph node was performed in order to elucidate possible characteristics relating to the risk of metastasis, with particular attention to the growth pattern of the primary tumor. All of the cases had at least one of the well-known risk factors for lymph node metastasis, including moderately or poorly differentiated histologic characteristics, considerable degree of submucosal invasion, and lymphatic invasion. An interesting finding of the present study was the identification of a nonpolypoid growth pattern with no concomitant adenomatous tissue, which seemed to be different from that of "malignant polyps" of previously reported cases showing adenoma-carcinoma sequence. This unique growth feature was found in all of the cases. Therefore, in addition to the accepted risk factors, nonpolypoid growth pattern and absence of adenomatous component may be risk factors predictive of nodal metastasis in patients with early invasive colorectal carcinoma.

[Prediction of recurrence of gastrointestinal cancer from standpoint of biological malignancies--tumor marker doubling time and its a half life period line]

It is well generally accepted that several tumor markers may be useful for determination of staging, metastatic patterns, devices of the malignancy and prediction of recurrence in postoperative follow-up. Our analysis of tumor markers in gastrointestinal cancer indicated that the patients who had a high level of AFP in the serum of gastric cancer patients showed a correlation between preoperative AFP level and liver metastasis. In patients with carcinomatous peritonitis positive rate of CA125 level in serum was 42.9% and, more importantly, the elevation of CA125 level after surgery was observed in 72.2% of patients complicated peritoneal dissemination before clinical evidence. On the other hand, the change of tumor marker levels in serum after surgery were plotted on a semi-logarithmic scale and we monitored tumor marker changes until the level decrease to the normal range or when recurrence was detected on imaging diagnosis. All patients showing high levels of CEA had surgical resection for gastrointestinal cancers. In the group of 25 patients who had no recurrence within 1 year or more, CEA levels decreased exponentially until these reached the normal range. The half life period of CEA was 4 to 5 days. However, CEA levels in 13 of 19 patients who recurred showed a dissociation from the theoretical line of half life period before the level decreased to normal range. We interpreted that this dissociation was caused by the growth of residual cancer cells. In other word, if dissociation point from exponential decrease line of CEA were pointed after the surgery, we can predict a possibility of recurrence in earlier period after surgery.

Tissue inhibitor of metalloproteinase 1 is a negative regulator of the metastatic ability of a human gastric cancer cell line, KKLS, in the chick embryo

Tissue inhibitors of metalloproteinases (TIMPs) are the negative regulators of matrix metalloproteinases that degrade extracellular matrix. We examined the regulatory role of TIMP-1 in the metastatic activity of human gastric cancer cell lines in chick embryos because unregulated matrix metalloproteinase activities are believed to be essential during metastatic processes. One of the nine cell lines examined, KKLS cells, formed metastatic colonies in the chick livers. These cells expressed undetectable levels of TIMP-1, and this was not inducible by 12-O-tetradecanoylphorbol 13-acetate. Derivatives of KKLS cells with different levels of TIMP-1 expression were prepared by transfection of the human TIMP-1 complementary DNA controlled by a simian virus 40 early promoter. Metastatic abilities were suppressed by almost 70% in the transfectants expressing high levels of TIMP-1. In contrast, no suppression was observed in the control transfectants or in cells expressing the transfected TIMP-1 gene at low levels. These data indicate that a reduced expression of TIMP-1 in KKLS cells is responsible for their consequent metastatic potential. Moreover, it suggests that matrix metalloproteinase enzymatic activities are a prerequisite for metastatic activity in this experimental model system.

Otoneurological functioning in panic disorder patients with prominent dizziness

Fifteen panic disorder patients with prominent dizziness underwent audiologic, caloric, and vestibuloocular reflex activity testing and were compared with normal controls. There were no abnormalities detected on audiologic and caloric tests. Compared with normal controls, panickers with dizziness showed a greater discrepancy between eye and head movements on vestibulo-ocular reflex activity in the dark. Panickers with prominent dizziness did not differ from a second control group of panickers with severe heart palpitations on a number of psychological tests. The results did not support the hypothesis that organic dizziness is etiologically important in the causation of panic or agoraphobia, but do suggest that vestibuloocular reflex activity should be further studied in panic disorder.

Rapidly growing mucinous cholangiocarcinoma

A 65-year-old man was hospitalized due to an abdominal tumor. Several imaging studies showed multilocular tumors in the right hepatic lobe and in the pancreatic head, 4 and 7 cm in size, respectively. The hepatic tumor rapidly grew to 9 cm in 4 weeks, associated with a rapid increase in the serum carcinoembryonic antigen level from 125 ng/ml to 1,000 ng/ml. The pathologic diagnosis of the resected liver tumor was mucinous cholangiocarcinoma. This hepatic tumor produced a large amount of mucin, but did not secrete mucin into the bile ducts. Therefore, there was no obstructive jaundice. The incidentally accompanied pancreatic tumor was a typical serous cystadenoma. The present case suggested that mucinous cholangiocarcinoma could present rapid growth of the tumor. The clinicopathological features of mucinous cholangiocarcinoma are demonstrated for the first time, and the differences between mucinous cholangiocarcinoma and mucin-producing papillary adenocarcinoma of duct-spreading type are discussed.

Tumor necrosis factor alpha and interferon gamma synergistically induce interleukin 8 production in a human gastric cancer cell line through acting concurrently on AP-1 and NF-kB-like binding sites of the interleukin 8 gene

Interleukin 8 (IL-8) is a novel cytokine which possesses neutrophil chemotactic and activating activities in addition to chemotactic activity for basophils and T lymphocytes. It has been shown that IL-8 is produced by a variety of human somatic cells including monocytes/macrophages, dermal fibroblasts, vascular endothelial cells, keratinocytes, mesangeal cells, and several types of tumor cell lines. We have examined here whether or not human gastric cancer cell lines produce IL-8 in vitro. The production of IL-8 protein was detected by enzyme-linked immunosorbent assay in the culture supernatants derived from eight of nine human gastric cancer cell lines stimulated with either interleukin 1 alpha (IL-1 alpha), tumor necrosis factor alpha (TNF alpha), or TNF alpha plus interferon gamma (IFN gamma). In some of the gastric cancer cell lines such as MKN 45 and KATO, TNF alpha plus IFN gamma synergistically induced the production of IL-8. In MKN 45 cells, synergistic increase of the steady state level of IL-8 mRNA by TNF alpha plus IFN gamma was not inhibited by cycloheximide treatment. Scatchard analysis revealed that IFN gamma changed neither the number nor the affinity constant of TNF alpha binding sites on a gastric cancer cell line, suggesting that the synergism was a post-receptor event. Furthermore, synergistic induction of chloramphenicol acetyltransferase activity by TNF alpha plus IFN gamma was observed in MKN 45 that were transiently transfected with chimeric chloramphenicol acetyltransferase reporter genes driven by the transcriptional regulatory region of human IL-8 gene. Through the mutation of the regulatory region of the IL-8 gene, both AP-1- and NF-kB-like factor binding elements were presumed to be involved in conferring the responsiveness to TNF alpha plus IFN gamma. Moreover, gel retardation analyses revealed that TNF alpha and IFN gamma synergistically induced the binding of NF-kB like as well as AP-1 like proteins bound to these sites. These results indicated that IFN gamma synergistically enhanced TNF alpha-induced IL-8 production in a human gastric cancer cell line through synergistic activation of transcription factors without up-regulating TNF alpha receptor.

[Controversy between endoscopic and surgical treatment against early gastric and colorectal cancer]

Although endoscopic treatment against the patients with early cancer in gastrointestinal tract is an excellent method especially in high aged or poor risk patients, there still exists controversy about the indication for endoscopic treatment because of deeper invasion of the cancer or lymph node metastases. In order to clarify whether the patient has a possibility of nodal involvement or not, we made the clinicopathological analysis concerning 220 cases with early gastric cancers and 118 cases with colorectal cancers. Our retrospective analysis shows that endoscopic resection can be indicated for small polypoid cancer less than 10 mm in size, excluding IIa + IIc type. As to small depressed type, this procedure should be applied for IIc type which is well differentiated adenocarcinoma without ulcer formation (U1 (-)). Regarding early colorectal cancer there has been many discussion how to treat the patients with sm-cancer. Based on our analysis of 39 cases with sm-cancer, we led to the conclusion that the characteristics of sm-cancer with lymph node metastases are i) massive invasion into submucosal layer, ii) positive lymphatic permeation, or iii) "de novo" cancer. As a result, a decision of further surgery should be made even in small lesions less than 10 mm, taking the fact into consideration of the possibility of nodal involvement of sm-cancer.

Evaluation of basic procedures for adoptive immunotherapy for gastric cancer

Peripheral blood lymphocytes (PBL) of gastric cancer patients in advanced stages showed lymphokine activated killer (LAK) activities comparable to those of healthy donors, suggesting potential applicability of LAK cells induced from PBL stimulated with recombinant interleukin-2 (rIL-2) in adoptive immunotherapy (AIT) for gastric cancer. In order to generate a large number of LAK cells from PBL, lymphocytes were cultured with both rIL-2 and phytohemagglutinin (PHA). In this culture, the numbers of cells increased to a greater extent than those in culture with rIL-2 alone but cytotoxic activity did not augment, thus suggesting that this procedure would not afford sufficient clinical effects. On the other hand, a large number of LAK cells with high anti-tumor activities were efficiently induced from spleen cells of the patients by culture of rIL-2; hence clinical usefulness of these LAK cells is anticipated. In regional lymph node lymphocytes (RLNL) cultured with rIL-2, the cytotoxic activities were lower than in those induced in PBL, and a characteristic increase of CD8 + CD11 + suppressor T cells was observed after incubation with rIL-2. Nevertheless, an increase of CD4 + 4B4 + helper inducer T cells was also observed in RLNL after the culture with rIL-2. Furthermore, high cytotoxic activities were induced in RLNL in some cases in which metastasis to the regional lymph nodes was not detected. When gastric cancer patients were pretreated with biological response modifiers (BRM), especially with Lentinan, LAK cells from PBL showed higher NK and LAK activities as compared with those of patients without BRM pretreatment.

[Clinical significance of serum CA 125 values in patients with gastric cancers--especially correlation with peritonitis carcinomatosa]

A study of 387 patients with gastric cancers revealed elevation of CA 125 in sera of 7.2% of the patients. Patients with Borrmann 1 and 2 in gross type, poorly differentiated adenocarcinoma in histological type and stage 4 in stage grouping of gastric cancer, showed a higher positive rate than patients with the others. In patients with peritonitis carcinomatosa, positive rate of serum CA 125 was 42.9% of patients with synclonus metastasis, 72.2% with metaclonus metastasis. Elevation of serum CA 125 was observed earlier than detection by image diagnosis in almost all cases. These results indicate that CA 125 is an useful tumor marker for detection and follow up of patients with peritonitis carcinomatosa from gastric cancers.

[Significance of CA72-4 as a follow up of recurrent gastric cancer--comparison with CEA and CA19-9]

We studied a significance of serum CA72-4 as a follow up of recurrent gastric cancer in 24 recurrent cases with gastric cancer performed combination assay of CEA, CA19-9 and CA72-4. Positive rate of CA72-4 was 58.3%, which was almost same as that of CEA. Lymph node metastasis and peritoneal dissemination were observed relatively high rate in positive cases with serum CA72-4. Comparison of an elevation time of CEA and CA72-4 in recurrent cases showed that CEA earlier than CA72-4 was 3 cases, CA72-4 earlier than CEA was 3 cases, and the others were about same. These results indicated that CA72-4 was a useful tumor marker as a follow up of recurrent gastric cancer.

Experimental metastasis of oncogene-transformed NIH 3T3 cells in chick embryo

By means of a highly sensitive and quantitative assay for specific detection of metastasized tumor cells in chick embryonic organs using the polymerase chain reaction (PCR), we have examined the experimental metastatic ability of individual clones of NIH 3T3 cells, transformed with oncogenes: v-Ki-ras, v-Ha-ras, v-src, v-fos, and v-abl. Such a transformed clone had different metastatic abilities in different embryonic organs. Among them, two clones of NIH 3T3 cells transformed with ras-oncogenes (v-Ki-ras or v-Ha-ras) metastasized to liver and lungs of chick embryo, and grew there more rapidly than the other clones. The parental NIH 3T3 cells were detected as slight bands of PCR products after iv injection, indicating some cells were trapped in chick embryonic organs, but did not grow. These findings indicate that the transformed cells are able to invade the organ tissues and grow in embryonic chick organs, but non-metastatic cells such as the untransformed-NIH 3T3 cells are not able to grow in the secondary sites. These experiments clearly demonstrate the usefulness of this assay system to study genes involved in malignant transformation.

Expression of genes encoding type IV collagen-degrading metalloproteinases and tissue inhibitors of metalloproteinases in various human tumor cells

Uncontrolled expression of matrix metalloproteinases 2, 3 and 9 (MMP-2, -3 and -9) is believed to be a critical part of the invasive potential of tumor cells because of their ability to degrade type IV collagen, a major structural component of basement membranes. Availability of proteolytic activity in the vicinity of the cell surface is further affected by a local balance between the enzymes and their inhibitors produced by the cell. To determine how frequently deregulated expression of the MMPs and tissue inhibitors of metalloproteinases (TIMPs) is associated with tumor cells, 26 human tumor cell lines were examined by Northern blotting. Transcripts for MMP-2 and MMP-9 were more frequently expressed in mesenchymal tumor cells (9/9 for MMP-2 and 6/9 for MMP-9) than in epithelial tumor cells (4/17 for MMP-2 and 2/17 for MMP-9). Although expression of MMP-2 mRNA was clearly cell type-specific, MMP-9 mRNA expression in mesenchymal cells correlated well with the reported tumorigenicity of the cells. Enhanced expression of MMP-9 mRNA was also associated with the tumorigenic transformation of cells by an activated c-H-ras gene in human embryonic fibroblasts. Only 3 of the 26 tumor cells expressed MMP-3 mRNA, and 2 of the 3 were epithelial tumor cells which coordinately expressed MMP-9 and TIMP-1 mRNAs. TIMP-1 mRNA was almost undetectable in 50% of the tumor cells, but TIMP-2 mRNA was expressed in the majority of the cells. These findings provide comprehensive information about mRNA expression of the MMPs and TIMPs in tumor cells, the deregulation of which is thought to be an integral part of the invasive potential of tumor cells.

Establishment of a human chorionic gonadotropin-producing human gastric carcinoma in nude mice

A human chorionic gonadotropin (HCG)-producing gastric carcinoma was transplanted into BALB/c nu/nu nude mice. The original tumor tissue had been obtained by gastrectomy from a 55-year-old patient with gastric carcinoma. The tumor was transplanted serially in nude mice, and its doubling time was stable to approximately 12 days. A positive correlation was observed between serum HCG level and tumor weight. The serum HCG level of the mice and the histology of the tumor weight. The serum HCG level of the mice and the histology of the tumor, papillary adenocarcinoma with partial poorly differentiated adenocarcinoma, did not change on serial transfers. HCG was positively stained by an immunochemical technique only in the site of the poorly differentiated adenocarcinoma, while staining was negative in the site of the papillary adenocarcinoma, which constituted most of the tumor. These results indicate that this tumor in nude mice will be useful not only as a therapeutic experimental system but also for studying the potential malignancy of HCG-producing cancer cells.

[The growth rate as a parameter of degree of biological malignancy and prediction of metastasis by tumor marker doubling and half time]

We calculated the tumor marker doubling time and half time of many cases with gastric cancer and colorectal cancer and studied significance of those as a prediction of metastasis. Tumor marker doubling time of liver metastasis (28.4 +/- 11.5 days) in 32 cases was significantly shorter from that of lymph node metastasis (42.3 +/- 21.4 days) in 18 cases and of peritonitis carcinomatosa (41.1 +/- 25.8 days) in 21 cases. These result indicate that the tumor marker doubling time will be able to play a role in prediction of recurrent patterns. Tumor marker half time after operation ranged from 4 to 5 days in all cases without recurrence, while the discrepancy from actual half time was observed in cases with metachronous liver metastasis diagnosed within 6 months. These results suggest that the discrepancy from actual half time of tumor marker after operation indicates the latent cancer cells and this plays a role in prediction of metachronous liver metastasis.

[Experimental study on local attachment of Beriplast P membrane including MMC]

We studied the effect of Beriplast P membrane including MMC (2 mg/ml) on human gastric carcinoma implanted in nude mouse (OSS) as a example of a shallow but broad lesion as with an early-stage local recurrence of rectal cancer and superficial gastric cancer. As a result, the resected tumor contact Beriplast P membrane including MMC after 3 days showed continuous necrotic lesions, from 1 to 2 mm in depth. No side effect was observed in nude mice. These results indicated that Beriplast P membrane including MMC is a useful chemotherapy against local cancerous lesion.

[Arterial infusion chemotherapy combined with biochemical modulation in cancer patients]

Both arterial infusion chemotherapy and biochemical modulation are effective for unresectable and recurrent cancer patients. Thus, we tried to combine these methods and studied their combined efficacy in 30 cancer patients. Overall effectiveness was 40% with this method. The efficacy of each regimen, such as beta-MF and CF, was approximately 36.4% and 66.7%, respectively. The effectiveness of cannulation into the proper hepatic artery and aorta was 48.6% and 16.7%, respectively. In this study, there were no serial or severe side effects. These findings suggested that arterial infusion chemotherapy in combination with biochemical modulation was a safe and effective method for treating cancer patients.

A limitation of endoscopic ultrasound: an unusual case of early gastric cancer overlying a pancreatic rest

Endoscopic ultrasonography (EUS) has been developed as a valuable tool for examining the depth of carcinoma invasion and evaluating the submucosal tumors of the gastrointestinal tract. In the present case, that of a 60-yr-old woman, the work-up of radiography and conventional endoscopy revealed an ulcerating cancer of the stomach. Subsequent EUS showed a solid high-echoic mass occupying the third (submucosal) and fourth (muscularis propria) layers of gastric wall, suggestive of an advanced cancer invading the muscularis propria. However, histologic examination of the surgical specimen showed that this tumor was early submucosal carcinoma confined to the surface of a pancreatic rest. Retrospective evaluation of EUS pictures proved that the mass had tubular or circular echoless structures associated with thickening of the fourth layer, suggesting the pancreatic rest. Our experience in reviewing EUS findings of this tumor seems noteworthy, inasmuch as EUS indicates that EUS may provide certain characteristic features of gastric pancreatic rest that should be differentiated from invading carcinoma.

[Tumor markers--personal experience. How to read time course of some values and tumor marker doubling time]

Tumor marker doubling time is based on essential exponential curve of it. In this paper, we studied significance of tumor marker doubling time about 3 point: 1) time course of values, 2) Cancer growth, 3) Correlation between cancer growth and tumor marker. And we introduce the clinical application of tumor marker doubling time as a evaluation of survival time after chemotherapy, and the easy method of calculation of tumor marker doubling time.

Predominant Paneth cell differentiation in an intestinal type gastric cancer

A distinct morphological variant of a diffuse type adenocarcinoma of the stomach with Paneth cell differentiation is reported. The tumor was a Borrmann's Type III carcinoma measuring 6.0 x 5.5 cm at the body along the greater curvature. It was composed of Paneth cell- and endocrine cell differentiated cancer cells in addition to tubular and poorly differentiated adenocarcinoma cells. The Paneth cell differentiation was characterized histologically by cytoplasmic distinct coarse eosinophilic granules stained red with periodic acid-Schiff and Masson trichrome reagents and reddish brown with phosphotungstic acid hematoxylin, and electron microscopically by lysozyme in cytoplasmic electron dense granules. In addition, electron microscopy revealed acid mucin globules and various intermediate forms between Paneth granules and the mucin globules which might be regarded as abortive forms of Paneth granules presumably resulting from defective incorporation of lysozyme-positive mucosubstances into acid mucin. Endocrine differentiated cancer cells consisted of serotonin-, peptide YY-, and glucagon/glicentin-positive cells. The various cell phenotypes found in the present tumor could be explained on the basis of intestinal differentiation of gastric cancer.

The changing direction of nystagmus in acute Menière's disease: pathophysiological implications

The direction(s) and pathophysiologic basis of nystagmus during an acute attack of Menière's disease have been subject to much debate in the world literature. Clinical recordings from two patients whose nystagmus was captured near the very beginning of the acute vertiginous episode are presented. Previous clinical observations in Meniere's disease, experimental animal models concerned with initiation of peripheral nystagmus, and the phenomenon of recovery are discussed.

Anisakiasis of the colon: report of two cases with emphasis on the diagnostic and therapeutic value of colonoscopy

Anisakiasis of the colon is a rare entity as compared with gastric anisakiasis, and its diagnosis is very difficult. We present here two cases--a 42-year-old woman and a 30-year-old woman--of anisakiasis of the colon treated by colonoscopic removal of the worm without surgery. The importance of colonoscopy for the diagnosis and treatment of this disease is briefly discussed.

Expression of placental alkaline phosphatase in gastric and colorectal cancers. An immunohistochemical study using the prepared monoclonal antibody

The authors developed monoclonal antibodies (MoAb) against human placental alkaline phosphatase (PLAP). Four specific MoAb reacting only with PLAP and two nonspecific MoAb reacting equally with isozymes of alkaline phosphatase (hepatic, intestinal, and placental) were obtained. Immunohistochemical staining with the specific MoAb showed that the cell membrane and cytoplasm of cancer cells were stained in gastric and colorectal carcinoma. The incidence of PLAP positivity was 23% (25 of 107) of all gastric carcinomas. Among gastric carcinomas, the 42% (13 of 31) positivity of highly differentiated carcinoma (papillary adenocarcinoma and well-differentiated tubular adenocarcinoma) was a significantly higher rate than that found in poorly differentiated carcinoma (poorly differentiated adenocarcinoma and signet-ring cell carcinoma, five of 41, 12%). The incidence of PLAP positivity was 11% (four of 35) in colorectal carcinoma. In contrast, gastric adenoma, intestinal metaplasia, and noncancerous tissue adjacent to cancer did not show staining. These results indicated that expression of PLAP was apt to occur in more highly differentiated gastric carcinoma and was highly specific for carcinoma in the gastrointestinal tract, although its incidence was not high.

Medullary carcinoma with lymphocytic infiltration of the stomach. Clinicopathologic study of 27 cases and immunohistochemical analysis of the subpopulations of infiltrating lymphocytes in the tumor

The current study attempts to clarify the possible immune response that occurs in medullary carcinoma with lymphocytic infiltration of the stomach by an immunohistochemical analysis of the subpopulations of tumor-infiltrating lymphocytes. This carcinoma was histologically characterized by the sparse population of small nests consisting of poorly differentiated carcinoma cells, widely separated by intervening nondesmoplastic stroma infiltrated uniformly with abundant lymphocytes frequently accompanied by lymph follicles. An immunohistochemical analysis revealed that T-cells were evenly distributed throughout the tumor with intimate contact with individual carcinoma cells, except the lymph follicles consisted mainly of B-cells. Because of the similarities of morphologic features and subpopulations of tumor-infiltrating lymphocytes of this carcinoma to the normal lymphoid tissue, an organized immune response combined with cell-mediated and humoral immunities against the invading carcinoma cells seemed to occur in this type of gastric carcinoma, resulting in a excellent prognosis compared with that in ordinary gastric carcinoma.

Medullary carcinoma with lymphocytic infiltration of the stomach. Clinicopathologic study of 27 cases and immunohistochemical analysis of the subpopulations of infiltrating lymphocytes in the tumor

The current study attempts to clarify the possible immune response that occurs in medullary carcinoma with lymphocytic infiltration of the stomach by an immunohistochemical analysis of the subpopulations of tumor-infiltrating lymphocytes. This carcinoma was histologically characterized by the sparse population of small nests consisting of poorly differentiated carcinoma cells, widely separated by intervening nondesmoplastic stroma infiltrated uniformly with abundant lymphocytes frequently accompanied by lymph follicles. An immunohistochemical analysis revealed that T-cells were evenly distributed throughout the tumor with intimate contact with individual carcinoma cells, except the lymph follicles consisted mainly of B-cells. Because of the similarities of morphologic features and subpopulations of tumor-infiltrating lymphocytes of this carcinoma to the normal lymphoid tissue, an organized immune response combined with cell-mediated and humoral immunities against the invading carcinoma cells seemed to occur in this type of gastric carcinoma, resulting in a excellent prognosis compared with that in ordinary gastric carcinoma.

[Study of intraarteric infusion chemotherapy with drug delivery system]

We have studied the effect of intraarteric infusion chemotherapy with missile chemotherapy, induced hypertensive chemotherapy and/or two-route infusion chemotherapy in 14 liver tumors (7 cases with liver metastasis from gastric cancer, 3 cases with liver metastasis from colonic cancer, 4 cases with hepatoma). Results indicated that PR in 6 (46.1%) out the 13 evaluated cases. The toxicity was not evident except for slight bone marrow depression with 5 cases and a low grade fever with 2 cases. These results indicate that intraarterial infusion chemotherapy with drug delivery system can be considered one of the treatment therapies available for a nonresectable tumor.

The effect of UFTM therapy on primary and metastatic colon cancer from the same human xenotransplanted into nude mice

Successful simultaneous transplants of a cancer of the ascending colon from a 60 year old woman, taken from 3 sites: the primary focus, a lymph node metastasis, and a hepatic metastasis, into nude mice yielded KHC (-P, -N, -H) strains. These three strains were compared under uniform conditions of nude mouse transplantation from the standpoints of morphological variation, growth rate, and sensitivity to chemotherapy. The results showed no major differences in morphology or growth rate. However, an effect on chemotherapeutic sensitivity was observed in KHC-P and KHC-N, with reduction rates of 25.8 per cent and 31.4 per cent, respectively, in the MMC only treatment group with large doses, and in KHC-N and KHC-H, with reduction rates of 46.5 per cent and 34.9 per cent, respectively, in the UFTM group. Chemotherapy sensitivity not only exhibited heterogeneity by site, but also differed according to the chemotherapeutic agent used. These results indicate that this method of nude mouse transplantation is a good experimental system for comparing primary foci and metastases under uniform conditions, and also strongly suggest the presence of heterogeneity in sensitivity to chemotherapy.

[The preoperative and postoperative carcinoembryonic antigen test in the diagnosis, staging, and prognosis of gastric cancer. Tumor Marker Committee, Japanese Foundation for Multidisciplinary Treatment of Cancer]

Preoperative and postoperative carcinoembryonic antigen (CEA) levels were studied in 3,532 patients with Surgically treated gastric cancer in 52 institutions from 1980 to 1981. These patients had disease resectable with curative intent and were followed for a minimum of 5 years or until death. Among 2,749 Stage I cases, 33 had recurrence and proved to be histologically stage I. A pair matching case control study between these 33 cases and matched 33 stage I controls without recurrence proved that the preoperative CEA level was relatively higher in cases with recurrence (p = 0.079). In Stage II and III cases, an analysis of variance using a cut off level as a block factor was performed. Among 315 Stage II cases, preoperative CEA levels were significantly higher in cases with recurrence than in cases without recurrence. In 468 Stage III cases, no correlations between preoperative CEA levels and high risks of cancer recurrence were detected. In Stage I and Stage II cases, CEA levels significantly increased at the time of recurrence. In conclusion, preoperative high serum CEA levels might be considered one of the risk factors for recurrence of Stage I and II gastric cancers, and monitoring the postoperative CEA levels might be useful in early detection of recurrence.

Alpha-fetoprotein (AFP)-producing gastric carcinoma. Is it hepatoid differentiation?

Biochemical and immunohistochemical analyses were done on five cases of gastric carcinoma with excessive production of alpha-fetoprotein (AFP). Histologic and ultrastructural examination of these cases showed conventional poorly differentiated adenocarcinoma of cuboidal or polygonal tumor cells in the medullary area with scattered AFP-positive cancer cells. Comparative studies on serum AFP between these cases and in hepatocellular carcinoma (HCC) or in testicular yolk sac tumor cases using concanavalin A (ConA)-affinity and lens culinalis agglutinin A (LCA)-affinity sepharose columns revealed that the AFP derived from four cases had a high ConA nonadsorping rate and high LCA-reactive fraction similar to that of yolk sac tumor. The AFP from one case had a small LCA-reactive fraction similar to that of HCC. Further immunohistochemical study using several markers for liver cells or germ cell tumor did not show additional evidence of these tumor cells to differentiate into liver cells or yolk sac tumor cells. Thus, this study indicates that AFP-producing gastric carcinomas are not always derived from hepatoid differentiation of the foregut. These gastric carcinomas might be categorized into medullary tumor with gastrointestinal tract-specific AFP.

[Study on neoadjuvant chemotherapy of Borrmann 4 type carcinoma of stomach and its clinical significance]

Considering a high potential of biological malignancies of Borrmann 4 type carcinoma (abbr., Borr. 4) of the stomach, preoperative induction (neoadjuvant) chemotherapy was applied to patients with Borr. 4 as an initial therapy. Anticancer drugs used in this study were FAM-OK432, sequential MTX-5Fu or UFT-M through aortic infusion or induced hypertension chemotherapy (IHC) in order to obtain selective enhancement of drug delivery into tumor tissue. These trials were carried out on 24 patients who had Borr. 4 type carcinoma. The response to neoadjuvant chemotherapy showed CR in 1 case, PR in 3 cases and MR in 4 cases. The objective improvement except the primary gastric lesion showed shrinking of distant metastatic lymph nodes along paraaorta or Virchow of 50% (5/10), disappearance of pleural or peritoneal fluids 85. 7% (6/7) and marked decrease of tumor marker such as CEA, CA19-9 or CA125 100% (12/12). In one of 5 cases showing morphological improvement of primary gastric lesion, no viable cancer cells were seen in the stomach associated with multiple foci of granulofibromatous lesion of regional nodes. In 17 cases of 24 total gastrectomy was done with extended lymphadenectomy (R2-R3). While there was no difference in the median survival time (MST) among curable resection group, MST of non-curable resection group with neoadjuvant chemotherapy showed a fairly good prognosis for 14 months as compared to that of 4 months without chemotherapy. As for disease-free survival, patients whose tumor showed a high response to neoadjuvant chemotherapy had a good prognosis in non-curable resection group (p less than 0.01). In conclusion our results demonstrated that patients whose tumor were effectively destroyed by neoadjuvant chemotherapy against Borr. 4 carcinoma of stomach had an improved prognosis.

Laminin interactions with ductal pancreatic adenocarcinoma cells: identification of laminin- and collagen-binding proteins

Laminin promotes the modulation of human pancreatic adenocarcinoma cells from a proliferative to a resting phenotype. This process includes restoration of cell polarity, increase of protein biosynthesis, and increase of glycoprotein secretion. The growth correlates with the amount of laminin coated on the culture dish. Adenocarcinoma cells do not synthesize collagen type I, fibronectin or laminin. Prolonged propagation of the cells on laminin substratum enhances the expression of laminin-binding sites on the cell surface. Laminin binds to cell plasma membrane vesicles with a KB of about 2.2 × 10(10). By affinity chromatography of [35S]methionine-labeled, detergent-extracted, cells on immobilized laminin, a Mr 82,000 polypeptide could be enriched. By simultaneous chromatography on immobilized collagen type I, a Mr 34,000 polypeptide was retained. In laminin overlay experiments on transblotted plasma membrane proteins, Mr 82,000 and 70,000 polypeptides were labeled. Affinity chromatography on laminin-Sepharose of tumor cell membranes from cells grown in nude mice tumors retained Mr 100,000, 82,000, 70,000 and 55,000 polypeptides bound to the column. Endoglycosidase F treatment of these proteins reduced the number of higher Mr proteins, leaving a Mr 70,000 polypeptide, together with smaller peptides. Using the enriched binding protein fraction as antigens, monoclonal antibodies (mAbs) were prepared in mice. Two of the mAbs were further analysed; they recognized simultaneously the complete pattern of high and low Mr polypeptides identified to date by the other methods. Antibody 2A1-H7 was capable of inhibiting attachment and spreading of the cells on laminin and collagen I, but not on tissue-culture plastic. These data may indicate a molecular heterogeneity, partly based on diverse glycosylation, responsible for the variations in the molecular weight of the binding proteins. The adaptation processes of the tumor cells during growth on the extracellular matrix may indicate a regulatory function on tumor growth and metastasis in vivo.

On the search for markers of poor vestibular compensation

The effectiveness of pursuit gain, cancellation of the vestibulo-ocular reflex, and a clinical oscillopsia test were assessed as vestibular function tests and tests that may allow prediction of which patients would compensate poorly after vestibular surgery. Cancellation of the vestibulo-ocular reflex in 17 patients and 17 control subjects was compared. Pursuit gain for 17 patients was determined for three frequencies at peak velocities of 25 and 50 degrees/sec. The oscillopsia test was administered to seven patients during at least the first 6 postoperative months. We are unable to state that any of these parameters were effective "markers" of impaired compensation, but the oscillopsia test appears to be a useful clinical tool for vestibular examination.

[A clinicopathological study on colonic carcinomas arising from right side colon]

This paper discusses the clinicopathological characteristics of colonic carcinomas arising from right side colon. Out of 214 cases of resected colonic carcinomas during the past 13 years, 36 cases of a right side colon carcinoma (in the cecum, in the ascending colon, or in the hepatic flexure) were encountered. Several characteristics have been associated with this type of cancer. They are as follows: 1) in half of these cases an abdominal pain but no anal bleeding, as has been noted in carcinomas of the sigmoid or rectum; 2) in histological type, poorly differentiated adenocarcinomas or mucinous carcinomas in 30.5% of these 36 cases, and associated with a far distant nodal involvement (n3, n4) in advanced carcinomas; and 3) although there was no difference in the 5-year survival rate between a right side colon carcinoma or a colon carcinoma at another site, the prognosis for those given a curative resection for a right side colon carcinoma was poor--only 22% due to hepatic metastases, indicating that colonic carcinomas of the right side has a poor prognosis due to the subsequent risk of highly potential malignancies.

[A comparative study of the biological behavior of gastric cancer from the view of the amount of connective tissue in the cancerous tissue--a correlation between the amount of connective tissue and the metastatic pattern]

Differences between advanced gastric cancer of the medullary type (med.: 138 cases) and the scirrhous type (sci: 164 cases) with regard to the amount of connective tissue that was cancerous have been studied clinicopathologically. A correlation was found between med and liver metastasis, and sci and peritoneal dissemination in metastatic types, whereas no correlation was observed in other factors except between med and a localized type, sci and infiltrating type in gross type. The study of tumorigenicity in nude mice showed remarkable difference between med (86.7%) and sci. (0%). These results indicate that there is definite relationship between the amount of connective tissue and the biological behavior of a gastric cancer.

[Preventive hepatic arterial infusion in high risk cases of liver metastasis from gastric cancer]

Preventive hepatic arterial infusion (MMC 20 mg, 5-FU 500 mg; one-shot) was applied to high risk cases of liver metastasis from gastric cancer. Postoperative liver metastases were found in 5 (16.1%) of 31 arterial infusion patients, against 9 (25.7%) of 35 controls. The average interval to recurrence from operation was 6.8 +/- 3.0 (SD) months in arterial infusion, against 5.4 +/- 3.0 months in controls. These results suggest that preventive hepatic arterial infusion will decrease the rate of postoperative liver metastasis from gastric cancer.